N-Acetylcysteine in the Treatment of Pediatric Tourette Syndrome: Randomized, Double-Blind, Placebo-Controlled Add-On Trial

被引:20
|
作者
Bloch, Michael H. [1 ,2 ]
Panza, Kaitlyn E. [3 ]
Yaffa, Alisa [4 ]
Alvarenga, Pedro G. [5 ]
Jakubovski, Ewgeni [1 ,2 ]
Mulqueen, Jilian M. [1 ,2 ]
Landeros-Weisenberger, Angeli [1 ,2 ]
Leckman, James F. [1 ,2 ]
机构
[1] Yale Univ, Sch Med, Yale Child Study Ctr, New Haven, CT USA
[2] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA
[3] Arizona State Univ, Dept Psychol, Tempe, AZ 85287 USA
[4] Tourette Syndrome Assoc, Northern Calif & Hawaii Tourette Syndrome Chapter, Bayside, NY 11361 USA
[5] Univ Sao Paulo, Sch Med, Dept & Inst Psychiat, Sao Paulo, Brazil
基金
美国国家卫生研究院;
关键词
ACETYL-CYSTEINE; BEHAVIOR-THERAPY; TIC DISORDERS; CHILDREN; SCALE; TRICHOTILLOMANIA; SCHIZOPHRENIA; METAANALYSIS; GLUTATHIONE; RISPERIDONE;
D O I
10.1089/cap.2015.0109
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Current pharmacological treatments for Tourette Syndrome (TS), such as antipsychotic agents and -2 agonists, are moderately effective in the treatment of tics, but have substantial side effects that limit their use. N-acetylcysteine (NAC) modulates glutamatergic systems, and has been used safely as an antioxidant agent with minimal side effects for decades. NAC has been increasingly studied for the treatment of other obsessive-compulsive spectrum disorders. We aim to examine the efficacy of NAC for the treatment of pediatric TS in a double-blind, placebo-controlled, add-on study. Methods: Thirty-one children and adolescents 8-17 years of age with TS were randomly assigned to receive NAC or matching placebo for 12 weeks. Our primary outcome was change in severity of tics as measured by the Yale Global Tic Severity Scale (YGTSS), Total tic score. Secondary measures assessed comorbid obsessive-compulsive disorder (OCD), depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD). Linear mixed models in SAS were used to examine differences between NAC and placebo. Results: Of 31 randomized subjects, 14 were assigned to placebo (two females; 11.5 + 2.8 years) and 17 to active NAC (five females; 12.4 + 1.4 years) treatment. No significant difference between NAC and placebo was found in reducing tic severity or any secondary outcomes. Conclusions: We found no evidence for efficacy of NAC in treating tic symptoms. Our findings stand in contrast to studies suggesting benefits of NAC in the treatment of other obsessive-compulsive spectrum disorders in adults, including OCD and trichotillomania, but are similar to a recent placebo-controlled trial of pediatric trichotillomania that found no benefit of NAC.
引用
收藏
页码:327 / 334
页数:8
相关论文
共 50 条
  • [1] N-Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial
    Bloch, Michael H.
    Panza, Kaitlyn E.
    Grant, Jon E.
    Pittenger, Christopher
    Leckman, James F.
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 2013, 52 (03): : 231 - 240
  • [2] N-Acetylcysteine Add-On Treatment in Refractory Obsessive-Compulsive Disorder A Randomized, Double-Blind, Placebo-Controlled Trial
    Afshar, Hamid
    Roohafza, Hamidreza
    Mohammad-Beigi, Hamid
    Haghighi, Mohammad
    Jahangard, Leila
    Shokouh, Pedram
    Sadeghi, Masoumeh
    Hafezian, Hasan
    [J]. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2012, 32 (06) : 797 - 803
  • [3] N-ACETYLCYSTEINE IN CHILDREN WITH AUTISM: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL
    Gray, K. M.
    Dean, O. M.
    Villagonzalo, K.
    Dodd, S.
    Mohebbi, M.
    Vick, T.
    Tonge, B. J.
    Berk, M.
    [J]. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, 2015, 59 (09) : 790 - 791
  • [4] N-acetylcysteine add-on treatment leads to an improvement of fornix white matter integrity in early psychosis: a double-blind randomized placebo-controlled trial
    Klauser, Paul
    Xin, Lijing
    Fournier, Margot
    Griffa, Alessandra
    Cleusix, Martine
    Jenni, Raoul
    Cuenod, Michel
    Gruetter, Rolf
    Hagmann, Patric
    Conus, Philippe
    Baumann, Philipp S.
    Do, Kim Q.
    [J]. TRANSLATIONAL PSYCHIATRY, 2018, 8
  • [5] N-acetylcysteine add-on treatment leads to an improvement of fornix white matter integrity in early psychosis: a double-blind randomized placebo-controlled trial
    Paul Klauser
    Lijing Xin
    Margot Fournier
    Alessandra Griffa
    Martine Cleusix
    Raoul Jenni
    Michel Cuenod
    Rolf Gruetter
    Patric Hagmann
    Philippe Conus
    Philipp S. Baumann
    Kim Q. Do
    [J]. Translational Psychiatry, 8
  • [6] A double-blind placebo-controlled trial of N-acetylcysteine in the treatment of cocaine dependence
    LaRowe, Steven D.
    Kalivas, Peter W.
    Nicholas, Joyce S.
    Randall, Patrick K.
    Mardikian, Pascale N.
    Malcolm, Robert. J.
    [J]. AMERICAN JOURNAL ON ADDICTIONS, 2013, 22 (05): : 443 - 452
  • [7] Metoclopramide for the treatment of Tourette syndrome: A randomized, double-blind, placebo-controlled trial
    Nicolson, R
    Smith, J
    Castellanos, FX
    [J]. INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2004, 7 : S277 - S277
  • [8] Risperidone in the treatment of Tourette syndrome: A double-blind, placebo-controlled trial
    Dion, Y
    Annable, L
    Sandor, P
    Chouinard, G
    [J]. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2002, 22 (01) : 31 - 39
  • [9] Sodium Benzoate Add-on Treatment for Refractory Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Trial
    Lin, Chieh-Hsin
    Chang, Yue-Cune
    Lane, Hsien-Yuan
    [J]. INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2016, 19 : 196 - 196
  • [10] The Efficacy of Adjunctive N-Acetylcysteine in Major Depressive Disorder: A Double-Blind, Randomized, Placebo-Controlled Trial
    Berk, Michael
    Dean, Olivia M.
    Cotton, Sue M.
    Jeavons, Susan
    Tanious, Michelle
    Kohlmann, Kristy
    Hewitt, Karen
    Moss, Kirsteen
    Allwang, Christine
    Schapkaitz, Ian
    Robbins, Jenny
    Cobb, Heidi
    Ng, Felicity
    Dodd, Seetal
    Bush, Ashley I.
    Malhi, Gin S.
    [J]. JOURNAL OF CLINICAL PSYCHIATRY, 2014, 75 (06) : 628 - U95